| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
3,125 |
2,941 |
$598K |
| T4533 |
Youth sized disposable incontinence product, brief/diaper, each |
2,738 |
2,594 |
$502K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
1,148 |
1,098 |
$203K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
1,588 |
1,515 |
$202K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
2,380 |
2,267 |
$199K |
| A4554 |
Disposable underpads, all sizes |
2,251 |
2,201 |
$188K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
2,928 |
2,850 |
$172K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
1,520 |
1,312 |
$163K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
1,078 |
1,029 |
$156K |
| K0108 |
Wheelchair component or accessory, not otherwise specified |
324 |
222 |
$81K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
653 |
604 |
$59K |
| E2617 |
Custom fabricated wheelchair back cushion, any size, including any type mounting hardware |
13 |
12 |
$35K |
| E1161 |
Manual adult size wheelchair, includes tilt in space |
12 |
12 |
$33K |
| T4541 |
Incontinence product, disposable underpad, large, each |
727 |
683 |
$23K |
| E2609 |
Custom fabricated wheelchair seat cushion, any size |
13 |
12 |
$21K |
| A9901 |
Dme delivery, set up, and/or dispensing service component of another hcpcs code |
68 |
67 |
$9K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
40 |
34 |
$7K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
17 |
17 |
$3K |
| E0956 |
Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each |
15 |
15 |
$3K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
13 |
13 |
$2K |
| E2231 |
Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware |
13 |
13 |
$2K |
| E2211 |
Manual wheelchair accessory, pneumatic propulsion tire, any size, each |
27 |
27 |
$2K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
15 |
15 |
$2K |
| K0040 |
Adjustable angle footplate, each |
14 |
14 |
$2K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
12 |
12 |
$2K |
| E2213 |
Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each |
26 |
26 |
$2K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
30 |
30 |
$1K |
| E0961 |
Manual wheelchair accessory, wheel lock brake extension (handle), each |
13 |
13 |
$730.86 |
| T4542 |
Incontinence product, disposable underpad, small size, each |
27 |
24 |
$574.20 |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
18 |
15 |
$569.40 |